Abstract

Summary This study of 415 adolescent children examinedthe association between four different measures of bonemass and prevalent fracture (N=160 children). DXAmeasures and calcaneal ultrasound (but not radial ultrasoundor metacarpal index) were associated with upperlimb fracture, suggesting heel ultrasound is also a discriminatorof fractures in children.Introduction The aim of the study was to describe theassociation between different measures of bone mass andprevalent fracture in adolescents.Methods A total of 415 adolescents (150 girls and 265boys), mean age 16.3 years were examined. Dual energy Xrayabsorptiometry (DXA) measures were performed at hip,spine, radius and total body. Calcaneal bone ultrasoundattenuation (BUA), speed of sound (SOS), and stiffnesswere assessed by a Sahara densitometer. Radial ultrasoundSOS was assessed by a Sunlight 8000P machine. Metacarpalindex was calculated from a left hand X-ray. Prevalentfractures were assessed by questionnaire.Results A total of 160 adolescents (39%) reported at leastone previous fracture (106 upper limb, 53 lower limb, oneother for first fracture). Significantly lower DXA measures,heel BUA, and heel stiffness was observed in those with ahistory of upper limb fracture (all P<0.05). Despitesignificant correlations between all the bone mass measures,radial ultrasound and metacarpal index did notdiscriminate those with fracture from those without. Similar associations were present for number of fractures. No bonemeasure was able to discriminate lower limb fracture.Conclusions Both calcaneal quantitative ultrasound andDXA are able to discriminate adolescents with a historyof upper limb fracture from those without.